Abstract Details

Title Meta-analysis of Randomized Controlled Trials on Intravenous Recombinant Pro-urokinase in Acute Ischemic Stroke: Efficacy and Safety Evaluation

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-003

Objective

To evaluate the efficacy and safety of intravenous recombinant pro-urokinase in patients with acute ischemic stroke

Background

Recombinant human prourokinase (rhPro-UK) is a potential alternative to alteplase for acute ischemic stroke (AIS). This meta-analysis evaluates its efficacy and safety compared to alteplase.

Design/Methods A systematic review and meta-analysis following PRISMA guidelines included five randomized controlled trials (RCTs) with 3,774 AIS patients treated within 4.5 hours of symptom onset (rhPro-UK: n=1,883; alteplase: n=1,891). The primary !outcome was excellent functional recovery (modified Rankin Scale [mRS] 0–1 at 90 days). Secondary outcomes included good functional recovery (mRS 0–2 at 90 days), symptomatic intracranial hemorrhage (sICH), 90-day all-cause mortality, and functional independence (Barthel Index).

Results No significant differences were observed between rhPro-UK and alteplase in achieving mRS 0–1 at 90 days (RR 1.02, 95% CI [0.95–1.10], P=0.56) or mRS 0–2 at 90 days (RR 0.99, 95% CI [0.97–1.02], P=0.62). Rates of sICH (RR 0.75, 95% CI [0.24–2.39], P=0.63), 90-day mortality (RR 1.16, 95% CI [0.81–1.68], P=0.42), and Barthel Index scores (RR 1.00, 95% CI [0.97–1.03], P=0.95) were also comparable

Conclusions rhPro-UK is non-inferior to alteplase for AIS treatment within 4.5 hours. Its targeted fibrinolytic mechanism supports its potential as an alternative thrombolytic agent, but further large-scale RCTs are needed for validation.

Authors/Disclosures
Asmaa Z. Zakria (Al-Azhar university) PRESENTER	Dr. Zakria has nothing to disclose.
Asma Daoud, Jr., MD	Dr. Daoud has nothing to disclose.
Noha Hammad, MD	Dr. Hammad has nothing to disclose.
Salma S. Obaid, MD	Dr. Obaid has nothing to disclose.

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